All issues > Volume 52(2); 2009

Case Report

Korean J Pediatr. 2009;52(2):251-255. Published online February 15, 2009.

Atypical presentation of Kawasaki disease resembling a retropharyngeal abscess

Eu Jin EJ Kim¹, Young Su YS Lim¹, Ji Eun JE Yoon¹, Heon-Seok HS Han¹

¹Department of Pediatrics, Chungbuk National University, College of Medicine, Cheongju, Korea

Correspondence Heon-Seok HS Han ,Email: hshan@chungbuk.ac.kr

Abstract

Kawasaki disease is an acute systemic inflammatory disorder, the etiology of which has not yet been established. The clinical manifestations are non-specific and are common to many pediatric infectious and immunologic diseases. In 2 cases presenting fever, cervical lymphadenopathy, and retropharyngeal abscess-like lesions on the neck shown in a computerized tomography (CT) scan, the diagnosis of Kawasaki disease was delayed. The patients were not responsive to antibiotic therapy, and fluid collection was not found during retropharyngeal aspiration. They showed typical Kawasaki manifestations over time and atrioventricular valve regurgitation in the echocardiogram. A diagnosis of Kawasaki disease should be considered in similar cases of fever and cervical lymphadenopathy. A CT scan that shows a retropharyngeal abscess-like lesion on the neck can be a false positive finding, and other laboratory exams, including echocardiography, should be performed as early as possible to avoid unnecessary medical and surgical procedures.

Keywords :Mucocutaneous lymph node syndrome, Retropharyngeal abscess